"Time will pass... these moods will pass... and I will, eventually, be myself again."

It happens every month… You become a version of yourself that you have come to hate. You feel broken, disconnected from joy and love that you typically feel. You feel tense…so tense. Like your body could literally explode. Frustration, irritability, uncontrollable mood swings, deep sadness to deep rage. These all come flooding towards you at once and of course it is the people you love most that get the worst of it…the worst of you. And then, you get a burst of absolute guilt and shame around your inability to control your emotions and how you treated your loved ones. EVERY MONTH…

Defining PMDD

The Gia Allemand Foundation defines PMDD as: "a cyclical, hormone-based mood disorder with symptoms arising during the luteal phase of the menstrual cycle and lasting until the onset of menstrual flow. It affects an estimated 2-10% of women of reproductive age. While PMDD is directly connected to a woman’s menstrual cycle, it is not a hormone disorder. It is a suspected genetic disorder with symptoms often worsening over time and following reproductive events including menarche, ovulation, pregnancy, birth, miscarriage, and menopause.”

So… to sum that up, PMDD symptoms show up around the 14th day of your cycle (typically a week and a half to two weeks before your period starts). These symptoms build with the hormone levels in your body and typically start to fade and dissipate after you start your period and hormone levels begin to balance out.

THIS IS NOT PMS

PMS is a term that defines “normal” and typical symptoms that occur when women get their periods. PMDD is a much more significant disturbance of mood and emotion that often has a damaging impact on your life and relationships. It is the “evil twin of PMS,” looking very similar and sharing similar core traits, however PMDD having hidden villainous qualities that can cripple the life of the women suffering from it.

What PMDD Looks Like

The lack of suitable medical research makes it hard to identify the exact symptoms of PMDD, and they can vary from woman to woman. Below are the most common symptoms of PMDD. Keep in mind the intensity level of these symptoms is higher than “common” PMS symptoms.

Depression

Sadness

Hopelessness

Anxiety / Panic Attacks

Tension/Restlessness

Extreme Sensitivity / Mood Swings

Irritability

Rage / Anger

Suicidal Ideations

Racing thoughts / Difficulty Concentration

Relational Conflict

Low Self-esteem / Negative self-talk

Fatigue / Insomnia

Self-Harming

A Little History

PMDD was not recognized as a diagnosable disorder until May of 2013. Prior to that it was acknowledged as provisional due to insufficient research and was often treated as a low level depressive disorder that got worse during menstruation. This led many women to feel guilt and shame around their symptoms and be treated incorrectly for their struggles.

What PMDD Feels Like

Women suffering from PMDD have described it as feeling like a completely different person, as though you are living a different life. Here are some quotes from courageous women who chose to share their experience.

“I felt deep misery and severe panic attacks, and when in the thick of it, I felt as though I would always be this miserable and it wouldn’t go away.” - Marie, 31

“When I am in the worst of it, I feel as if my body could literally explode with the amount of tension I experience. The littlest things will completely overwhelm me to the point of inability to function and do daily tasks.” - Jennifer, 37

“I tend to be a perfectionist naturally but when it is the week before my period I am wholeheartedly convinced I am failing at everything in life, and that EVERYONE feels the same way. I am a complete irrational mess.” - Anita, 29

“I cry for a week… I am wrecked by any and all emotions. Songs, commercials, certain sounds, I’m crying. And not just a few tears shed, a deep, raw, ugly cry!” - Kendra, 40

“My husband was fearful of this time of the month, every month. Before we knew what was happening to me, and before we even knew what PMDD was, we used to fight a lot about how bad I got. It was so hard to explain to him what was happening for me when I didn’t even know myself. I felt GUILT like I’ve never felt about anything else in life.” - Lisa, 39

If you relate to these women, I hope this helps you know, YOU ARE NOT ALONE.You are not broken, you are not crazy.

Treatment

There are many different treatments for PMDD, some natural remedies as well as medications. Most commonly prescribed are antidepressants that slow the re-uptake of serotonin (SSRI’s: Prozac, Celexa, Effexor, etc.), which have shown to be an effective treatment of PMDD. These drugs decrease symptoms of PMDD more rapidly than typical depression or major depressive disorder, which means that women don't necessarily have to take them every day. Instead, these drugs are commonly prescribed to be taken as “luteal-phase” doses, beginning approximately 14 days before mensuration starts and ending shortly after.

How Therapy Can Help

PMDD can create shifts in our thoughts that can blind us to reality as well as disconnect us with our own inner strengths.

Therapy can help you find ways to create more clarity and ability to address our own damaging thoughts.

It can also help to ground you and connect you to who you are underneath the havoc that PMDD is wreaking on your life.

Therapy can also help heal any damage that PMDD has caused in your relationships as well as help you battle against any residual guilt or shame you may be feeling.

More than anything, therapy is place to be heard, to be understood, and to NEVER be judged for what you are feeling or experiencing.

Because PMDD is a fairly new diagnosis and less widely known by the general public it can be hard to find people to talk to and connect with. If you suffer from PMDD, I hope you will reach out for help and know you are not alone.